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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
general
Acute undifferentiated febrile illness in rural Cambodia: A 3-year prospective observational study
PLoS ONE, Volume 9, No. 4, Article e95868, Year 2014
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Description
In the past decade, malaria control has been successfully implemented in Cambodia, leading to a substantial decrease in reported cases. Wide-spread use of malaria rapid diagnostic tests (RDTs) has revealed a large burden of malaria-negative fever cases, for which no clinical management guidelines exist at peripheral level health facilities. As a first step towards developing such guidelines, a 3-year cross-sectional prospective observational study was designed to investigate the causes of acute malaria-negative febrile illness in Cambodia. From January 2008 to December 2010, 1193 febrile patients and 282 non-febrile individuals were recruited from three health centers in eastern and western Cambodia. Malaria RDTs and routine clinical examination were performed on site by health center staff. Venous samples and nasopharyngeal throat swabs were collected and analysed by molecular diagnostic tests. Blood cultures and blood smears were also taken from all febrile individuals. Molecular testing was applied for malaria parasites, Leptospira, Rickettsia, O. tsutsugamushi, Dengue - and Influenza virus. At least one pathogen was identified in 73.3% (874/1193) of febrile patient samples. Most frequent pathogens detected were P. vivax (33.4%), P. falciparum (26.5%), pathogenic Leptospira (9.4%), Influenza viruses (8.9%), Dengue viruses (6.3%), O. tsutsugamushi (3.9%), Rickettsia (0.2%), and P. knowlesi (0.1%). In the control group, a potential pathogen was identified in 40.4%, most commonly malaria parasites and Leptospira. Clinic-based diagnosis of malaria RDT-negative cases was poorly predictive for pathogen and appropriate treatment. Additional investigations are needed to understand their impact on clinical disease and epidemiology, and the possible role of therapies such as doxycycline, since many of these pathogens were seen in non-febrile subjects. © 2014 Mueller et al.
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https://efashare.b-cdn.net/share/pmc/articles/PMC3995936/bin/pone.0095868.s005.docx
Authors & Co-Authors
Mueller, Tara C.
Germany, Munich
Ludwig-maximilians-universität München
Sovannaroth, Siv
Cambodia, Phnom Penh
National Center for Parasitology, Entomology and Malaria Control
Khim, Nimol
Cambodia, Phnom Penh
Institut Pasteur du Cambodge
Kim, Saorin
Cambodia, Phnom Penh
Institut Pasteur du Cambodge
Fleischmann, Erna
Germany, Munich
Ludwig-maximilians-universität München
Ariey, Frédéric
France, Paris
Institut Pasteur, Paris
Buchy, Philippe
Cambodia, Phnom Penh
Institut Pasteur du Cambodge
Guillard, Bertrand
Cambodia, Phnom Penh
Institut Pasteur du Cambodge
González, Iveth J.
Switzerland, Geneva
Foundation for Innovative new Diagnostics, Switzerland
Christophel, Eva Maria
Philippines, Manila
The World Health Organization Regional Office for the Western Pacific Philippines
von Sonnenburg, Frank F.
Germany, Munich
Ludwig-maximilians-universität München
Bell, David R.
United States, Seattle
Global Good Intellectual Ventures Laboratory
Menard, Didier
Cambodia, Phnom Penh
Institut Pasteur du Cambodge
Statistics
Citations: 59
Authors: 13
Affiliations: 7
Identifiers
Doi:
10.1371/journal.pone.0095868
ISSN:
19326203
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Randomised Control Trial
Cross Sectional Study
Cohort Study